HomeMy WebLinkAboutRequest to Advertise - St. Joseph River Backwater Valves Project No 119-018BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date November 4, 2019
Name Roger T. Nawrot
Department Public Works
Division/Bureau Engineering
BPW Date November 12, 2019 Phone Extension 5932
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.. .. _ R ouired Prior to Submittal to Board .. .__....
Legal ❑ Attorney Name:
Controller ❑ Controller review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing ❑
Agreement
Professional Services
E] Bid Opening
Quote Opening
❑ Change Order No. _
�] Ease/Encroach.
Other:
Company or Vendor Name
LJ Contract
Resolution
El Bid Award
❑p Quote Award
0 C/O & PCA No.
❑ Traffic Control:
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Proposal
® Req. to Advertise
❑ PCA
Addendum
® Title Sheet
El Yes ® No.
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El If Yes, Approved by
Purchasina
MBE ..W.B E........
No Yes Name�of Com
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t. Joseph River Backwater Vammmmm_wws
119-018
Sewe....Fund ............w_......wm� ..............
226-0419-672.42-03
Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
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__ ......: ....... Roq Ji ed For Ch Me Orders Onff._..:.. w ..
Amount of El Increase $
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El Decrease $
Previous Amount $
Current Percent of Change: %
New Amount
Total Percent of Change %
Dispersal After Approval L n
Copy
Original
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